Nursing Commons^™

The Effect Of Shared Medical Appointments And Education On Hemoglobin A1c Levels, Gina L. Moore

Evidence-Based Practice Project Reports

Type II diabetes affects millions of people worldwide. Approximately 25.8 million or 8.3 percent of the United States (U.S.) population has type II diabetes. The number of adults in the United States developing diabetes has been projected to double by the year 2030 (World Health Organization, 2013). Diabetes is the leading cause of kidney failure and blindness, as well as the major cause of heart disease and stroke which is the 7th leading cause of death in the U.S. The purpose of this evidence-based project was to determine the effects of education during shared medical appointments with type II diabetic …

A Novel Method For Assessing Medication-Related Adverse Outcomes In A Community Hospital, Christopher M. Patty

Doctoral Projects

The use of medications for hospitalized patients is universal, and unfortunately medication-related adverse outcomes are common. The accurate assessment of medication-related harm in hospitalized patients is foundational to the development of an effective hospital medication safety program. Every hospital has its own unique "fingerprint" of harm, accurate determination of the nature of medication-related harm specific to each hospital is necessary to facilitate prevention of that harm with specific and effective interventions. This project has provided a community hospital with its first systematic methodology for assessing medication-related harm. The methodology is adapted from that used in a recent national-level study.

Several …

Nurses' Perceptions Of Structural Empowerment: A Practice Review Process Pilot, Andrea M. Lee-Riggins

Doctoral Projects

Nurses are professionally and morally obliged to monitor and evaluate nursing practice via active participation in review mechanisms that are designed to promote patient safety and care delivery, thereby improving patient care quality (American Nurses Association [ANA], 1988, 2001, 2004; O'Rourke, 2006). The purpose of this Doctor of Nursing Practice (DNP) project was to develop, pilot, and evaluate a nurse practice review process with frontline nurses within Fresno Heart & Surgical Hospital (FHSH), a small specialty hospital, affiliated with Community Medical Centers (CMC) in Fresno, California. A nurse practice algorithm was subsequently developed and structural empowerment was assessed with the …

Relationships Between And Among The Power Of Self-Care Agency, Perceived Structural Empowerment And Psychological Empowerment In Nurse Managers In Acute Care Hospitals With Magnet Designation, Patricia Anne O'Keefe

Seton Hall University Dissertations and Theses (ETDs)

Background: In today’s dramatically changing healthcare environment, the nurse manager’s role in an acute care hospital is critical to meet the increasing patient care demands and the goals of the organization. The literature provides consensus that optimal nurse manager role behaviors are essential to facilitate a successful unit based organizational structure that can sustain workplace success. These behaviors can be theoretically described as the result of a nurse manager’s ability as self-care agent to activate his or her power of self-care agency in order to engage in optimal role behaviors that will ultimately ensure that the goals of the …

Patient Navigator's Role Definition, Joann Smith

Nursing Theses and Capstone Projects

Patient navigation as a care coordination model continues to evolve. Early programs focused on access to care for the underserved and uninsured. With no standard credentials, title, training or job descriptions, navigator programs are as varied as the people who perform these duties. The nurse navigator provides a holistic approach to care delivery and focuses on care coordination, education, and physical, social and emotional aspects of care. Workload for the navigators is increasing as a result of patient, facility, departmental, and national accreditation demands. The goal of this capstone project was to redefine the job descriptions of the Oncology Nurse …

Relationship Between Job Satisfaction And Nurse To Patient Ratio With Nurse Burnout, Kayla Teeter

Nursing Theses and Capstone Projects

There is evidence that the increase in patients per nurse ratio and job dissatisfaction are leading causes of nurse burnout in the United States; however, current research mostly focuses on the hospital setting which limits the generalization of the findings. Therefore, more research is needed beyond the hospital environment. The purpose of this MSN thesis was to examine the relationship between job satisfaction and nurse-patient ratio with nurse burnout among home health nurses. The hypothesis is that home health nurses who experience a higher nurse to patient ratio and greater job dissatisfaction will experience increased nurse burnout. A review of …

Interprofessional Simulations: Student Attitudes And Effects On Sbar Performance, Michele A. Pfaff

Nursing Theses and Capstone Projects

National healthcare organizations recommend innovative educational initiatives and fundamental changes in the way healthcare providers are educated. Educational strategies that incorporate collaboration have been shown to impact professional behaviors and competency. Improved student attitudes toward collaboration and increased understanding of professional roles are impacted by exposure to simulation and interprofessional education. The purpose of the Interprofessional Simulation Project was to determine whether the type of clinical simulation experience (traditional versus interprofessional) influences nursing students' knowledge and performance of skilled communication. Additionally, the project investigated attitudes toward collaboration in an educational setting. A quantitative pretest and posttest design was utilized to …

Non-Pharmacological Interventions Project: Treatment For Dementia, Mandy Richards

Nursing Theses and Capstone Projects

In response to the Office of Inspector General's research report on atypical antipsychotic off label treatment of elderly dementia residents in long-term care, the Centers for Medicare and Medicaid Services developed a non-pharmacological intervention known as the Hand In Hand training tool. This projects focus was on training the direct care nursing staff with the Hand In Hand tool and evaluating for decrease in behavior and psychological symptoms in their patients. A retrospective chart review was utilized for the Minimum Data Sets tool Brief Interview of Mental Status (BIMS) and Mood interview. Pre training and post training scores were analyzed …

Nurse Manager Role Perception In An Acute Care Facility, H. Gale Waters

Nursing Theses and Capstone Projects

The Nurse Manager role is a crucial part of the healthcare delivery system in an acute care facility, particularly in the current wave of healthcare reform. These are unprecedented times for nursing leadership as they develop and move in a new direction. The role of Nurse Manager is complex with numerous studies including: past roles, characteristics, innovation, outcome, education, and advancement. This study observed the role through the point of view of the Nurse Manager. The Nurse Managers participated in a survey in which they ranked themselves on a one to five scale, with one being a novice in the …

Impact Of Nurse Managers' Leadership Styles On Staff Nurses' Intent To Turnover, Joseph Warren L. Perez

Nursing Theses and Capstone Projects

Nurse Managers have the unenviable responsibility of ensuring that nursing staff are engaged and perform their duties to the best of their abilities. Maintaining an environment conducive to maximizing nurses' potentials resulting in retention may be a by-product of an effective leadership style. The purpose of this study was to determine whether nurse managers' leadership styles have an impact on nurses' intent to turnover. Nurse Managers with more than one year of management experience were asked to complete the Multifactor Leadership Questionnaire (MLQ-5X). The 45-item questionnaire rates the participant's leadership style based on the answers provided. Results were then compared …

Nursing's Ethical Responsibilities In Value-Based Purchasing, Wendy B. Bailes, Marcia M. Rachel, Sheila Keller

Journal of Health Ethics

Healthcare changes have resulted in the development of reimbursement initiatives such as value-based purchasing. These initiatives are designed to improve quality of care, decrease healthcare costs and improve the perception of care. Many of the compliance mandates are related to care provided by the professional nurse. Ethical considerations of these mandates will be explored utilizing the American Nurses Association Code of Ethics.

Attitudes And Beliefs Of Registered Nurses About The Process Of Changing To An Electronic Medical Record In A Community Hospital: A Mixed Method Investigation, Roberta Jo Myers

Doctor of Nursing Practice Scholarly Projects

The change from paper charting systems to electronic medical records (EMR) is a daunting task. Many hospitals today are undergoing this process. Kotter’s Change Model informs us that the process must be guided by sound principles and lead by an engaged, focused team of dedicated employees. The studied hospital is a small hospital in rural Ohio that initiated this change in late 2012. Their computer charting initiative launched the EPIC program for EMR use throughout the facility. Nursing staff was challenged to learn and eventually become proficient in its use. Because nurses are the largest care provider group in any …

Development Of An Education Module On Conflict Resolution For Charge Nurses, Robert H. Petersson

Theses and Graduate Projects

A healthy work environment is essential for providing safe and efficient care for patients. When nurses avoid conflict on a patient care unit they create an unhealthy work environment by leaving problems unresolved. Avoiding conflict is common due to the perception that conflict is a negative outcome of dysfunctional relationships. In reality, conflict is a normal part of human interactions that stimulates individuals to adapt to the diversity that surrounds them. Increasing charge nurses‟ understanding of interpersonal conflict and improving their skills of constructive conflict resolution, supports the creation and maintaining of a healthy work environment. An education module titled …

A Healthy Work Schedule: Improving Dynamics For Nurses’ Health, Amy Schei

Theses and Graduate Projects

Rotating shift work is an unavoidable, integral aspect of nursing at a large hospital in the Midwest; however, the fatigue involved in rotating shift work is avoidable. Research has shown how fatigue related to rotating shifts can impact nurses and ultimately affect patients. Fatigue caused by rotating shift work has been proven to decrease nurses’ levels of alertness and vigilance, which directly correlates to higher incidences of errors with patients. In addition, nurses who work rotating shifts have been proven to have problems with psycho-physical health, biological functions, and social relationships. It is through an understanding of the risks related …

Advanced Practice Care Model In A Midwestern Allergy Clinic, Bernie Theobald

Theses and Graduate Projects

Health care organizations are creating innovative patient care models to deal with the rapidly changing healthcare environment. Implementation of the Affordable Care Act has led to reduced revenue for healthcare organizations and placed an impetus on quality. For healthcare providers to continue to practice, they must change their model of care. An allergy clinic in a large Midwestern healthcare organization created acare model which capitalizes on the unique skillset that nurses possess. Nurses in the care model contact the patient before their visit, assess patient needs, and follow-up with the patient in a post-consult nurse visit. The care model has …

Interprofessional Collaboration, Amy L. Brabec

Theses and Graduate Projects

The World Health Organization emphasizes the importance of interprofessional collaboration, which occurs when multiple health workers from different professional backgrounds work together with patients, families, caregivers, and communities to deliver the highest quality of care. As the blood and marrow transplant (BMT) practice continues to grow at a large Midwestern hospital, the need for improved interprofessional collaboration between the hospital-based nurses and the mrse coordinators in the outpatient clinic was apparent. Using Newman's theoretical framework of nurse-patient relationship, person-environment interaction, and rurses being fully present, the BMT partnership group was formed. An interdisciplinary group consisting of the hospital-based nurses and …

Nursing Bedside Shift Report: A Best Care Practice, Heather Gleason

Theses and Graduate Projects

For healthcare organizations, patient safety and satisfaction are major priorities and are impacted by many different professional disciplines. Nurses can influence this greatly through the relationships built with patients and the information provided to them regarding care while in the hospital. Communication errors are the leading cause of sentinel events for patients, reiterating the importance of having a safe transfer of care between nurses at shift change. Bedside shift report not only creates transparency of patient information but results in improved patient safety and hospital satisfaction scores. Completing nursing shift report at the bedside promotes patients' and families' contribution to …

Partnership, Maine Medical Center

Annual Reports

Biennial Report on Nursing, 2013-2014

Invited Speech: Evidence Based Practice: Acuity Based Care And Research Practice Change, Carolyn Lindgren

All Publications

No abstract provided.

Analysis Of Medication Workflow In An Intensive Care Unit, Claire Roth

Summer Community of Scholars Posters (RCEU and HCR Combined Programs)

No abstract provided.

Trauma Resuscitation Team Program Evaluation, Lisa J. Fryman

DNP Projects

To evaluate the effectiveness of a newly implemented charge nurse-led trauma resuscitation team approach in the Trauma Intensive Care Unit (TICU). The approach was developed to improve patient throughput efficiency at a Level 1 Trauma Center. Measures of effectiveness include patient throughput efficiency, patient clinical outcomes, and financial impact. The implementation of the charge nurse-led trauma resuscitation team showed an improvement in efficiency of patient throughput without adversely affecting patient outcomes, and opening up critical resources for the next patient that arrives.

Implementation Plan For Emr And Beyond, Lori Katterhagen

Doctor of Nursing Practice (DNP) Projects

Change is never easy for anyone, but how we implement change can make the difference in how an innovation is accepted. Over the last two years, a small community hospital in California has introduced a new electronic medical record (EMR) to meet the requirements of meaningful use mandated by the Centers for Medicare and Medicaid (CMS) for all hospitals across the United States. EMRs are expected to improve quality in many areas, especially to improve outcomes, while safely reducing costs (U.S. Department of Health & Human Services, 2012). Adoption of EMR’s is not optional, if facilities want to avoid penalties …

Lean Management Principles To The Creation Of Postpartum Hemorrhage Care Bundles, Bethan Faulkner

Doctor of Nursing Practice (DNP) Projects

Postpartum hemorrhage (PPH) is the number one cause of pregnancy-related death in the US. The Maternity local improvement team (LIT), co-led by an Obstetrician and Board Certified Clinical Nurse Specialist found that each month the maternity unit averages 40 PPHs with 1-2 resulting in an emergency. Over a 6-month period, the LIT decreased response time for emergencies significantly. Supply retrieval time decreased by 99.9%, MD response time decreased by 81%, and Family Centered Care increased by 100%. They recently turned their attention to prevention. Given the lack of literature on preventing PPH in postpartum units, the team developed a PPH …

Improving Value Based Purchasing Through The Implementation Of The Clinical Nurse Leader Role: The Chief Nursing Officer’S Case For Change, Leanne M. Hunstock

Doctor of Nursing Practice (DNP) Projects

The healthcare industry is focused on the implementation of the Affordable Care Act, the payment reform package from Centers for Medicare and Medicaid Services and the development of Accountable Care Organizations. The decisions, behaviors, and practices of medical and clinical staff directly impact patient care, quality, and subsequently cost and reimbursement. The imperative to balance quality and patient safety with cost effectiveness requires a complex orchestration of all the elements of care within the clinical microsystem. A priority is to support and enable bedside nurses’ daily practice, priorities, and decision-making. This can be accomplished through the implementation of the Clinical …

Innovative Approach To New Nurse Residency, Meaningful Use And Health Care Reform, Pamela V. Stanley

Doctor of Nursing Practice (DNP) Projects

The project’s aim was to examine the financial impact of replacing registered nurse (RN) travelers, RN registry and RN overtime with new graduate RNs. Newly graduated RNs are often viewed by hospital administrators as a more costly staffing resource. This project contributes knowledge regarding the potential cost savings with the utilization of a centralized float pool incorporating new graduates. In addition, it contributes a novel idea for reducing organizational costs of implementing an electronic medical record with the utilization of new graduates as super users.

A new graduate program, which incorporated the use of a formal preceptor and mentoring program, …

Influencing Change In Healthcare Providers: Communication Strategies For A New Era In Healthcare, Ceonne Raasikh

Doctor of Nursing Practice (DNP) Projects

Effective provider communication is the key to patient engagement. However, many providers are not able to effectively communicate with patients, in part due to low health literacy. Evidence in the literature supports the use of specific strategies aimed at improving communication with patients. The purpose of this quality initiative was to influence providers to adopt new communication strategies with their patients. Pharmacists, nurses and physicians were invited to participate in a free, full-day, educational event. During the event providers were alerted to the issue of health literacy and provided communication strategies to improve patient comprehension and engagement. Following the presentation, …

Perceptions Of A Dedicated Education Unit In The Mississippi Delta, Jacquelyn Felecia Brownlow

Doctoral Projects

The highest health care disparities in the country plague the Mississippi Delta. A weakened economy, minimal access to healthcare and an outdated traditional clinical learning environment place enormous strains on nursing education in this area to provide more nurses. The office of Nursing Workforce reported a 14% to 16% nursing turnover in the Delta compared to the national average of 13.5%. As a result, the health care organization has encountered high nurse turnover, increased staffing shortages, and a decrease in nursing quality indicators. As an effort to improve clinical education and bridge gaps between education and practice, several schools in …

The Reality Of Disaster: An Educational Template That Brings Community Into The Classroom, Mary T. Bouchaud Phd, Msn, Cns, Rn, Crrn, Edward H. Jasper Md

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Perceptions Of Workplace Bullying Among Practicing Registered Nurses, Crystal Regina Threadgill

Dissertations

Workplace bullying (WPB) is a social and organizational problem. Within the health care arena, employees, particularly registered nurses, are at risk. WPB has several adverse effects and has been cited in the literature as closely associated with burnout and nurses leaving their positions. This quantitative study examined workplace bullying among practicing registered and its relationship with burnout and nurses’ intent to leave their current position.

The surveys utilized were the Negative Acts Questionnaires-Revised (NAQ-R), Maslach Burnout Inventory Survey, Intention to Turnover Scale and a demographic survey. Of the surveys distributed, a total of 185 were returned from one selected hospital …

Academic Incivility In Nursing Education, Sherrie Marlow

Nursing Theses and Capstone Projects

A well-documented and growing problem impacting the nursing shortage in the United States is the increasing shortage of qualified nursing faculty. Many factors contribute to the nursing faculty shortage such as retirement, dissatisfaction with the nursing faculty role and low salary compensation (American Association of Colleges of Nursing (AACN), 2005; Allen, 2008; National League of Nursing (NLN), 2010; American Association of Colleges of Nursing (AACN), 2011). Academic incivility has been identified as contributing to nursing faculty role dissatisfaction (Clark & Springer 2010). Academic incivility diminishes the presence of a caring environment, lowers an individual's self-esteem, and negatively impacts the formation …